Microvascular Angina: Diagnosis, Prognosis and Treatment

The term ‘microvascular angina’, proposed in the late 1980s, defines patients presenting with symptoms and signs of myocardial ischaemia, despite the presence of angiographically normal coronary arteries. Over the past few decades, evidence has accumulate

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Essentials in Stable Angina Pectoris

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Essentials in Stable Angina Pectoris

Juan Carlos Kaski

Essentials in Stable Angina Pectoris

Juan Carlos Kaski Cardiovascular & Cell Sciences Res Inst St George’s University of London London UK

ISBN 978-3-319-41179-8 ISBN 978-3-319-41180-4 DOI 10.1007/978-3-319-41180-4

(eBook)

Library of Congress Control Number: 2016948438 © Springer International Publishing Switzerland 2016 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer International Publishing AG Switzerland

This book is dedicated to My wonderful wife, Marta, for her unconditional love and continued support and inspiration; my father, who is over 90 years of age and still practices medicine with great care and devotion; and to all medical practitioners who strive to improve their knowledge to provide better care for their patients.

Preface

Stable angina pectoris affects a large proportion of individuals in the general population. Recent data indicate that approximately seven million American people suffer from angina. This not only is a very frequent condition but one associated with an increased risk of major cardiovascular events, including myocardial infarction and cardiac death. Chronic stable angina also represents a major financial burden to many individuals affected by the condition and to health services worldwide. Angina is often, but not exclusively, caused by obstructive atherosclerotic coronary artery disease. Coronary atherosclerotic plaques causing progressive stenosis of the arterial lumen can lead to myocardial ischemia as a result of the restriction they impose to coronary blood flow. Coronary stenoses may thus limit the ability of the coronary circulation to meet an increased myocardial oxygen demand. The classical definition of angina based on the above mechanism is, unfortunately, applicable almost exclusively to myocardial ischemia